Plastic Embryos: The Detrimental Impact of using Plastics in Fertility Clinics

The fertility clinic industry is growing every year, currently valued at $2.7 billion in the U.S. (IBISWorld, 2022). Fertility clinics, alongside the rest of the medical industry, use plastics such as Polyvinyl Chloride (PVC) and Bisphenol A (BPA) in day-to-day objects such as IV bags, syringes and petri dishes. By now, we are all aware of the dangers of plastics, so why are we so comfortable using an overwhelming amount of plastic in our healthcare system? Many industries are actively reducing plastic consumption, so why should the medical industry be any different.

BPA is one of the highest volume chemicals in use today and few are exempt from exposure, with it being detectable in the urine of over 90% of populations in western countries (Castellini et al., 2020). It is an endocrine disrupting chemical, thought to increase your risk of cardiovascular disease, reproductive cancers, and diabetes, as well as reducing fertility sperm success rates in men (Cantonwine, Hauser, & Meeker, 2013). For women, reproductive cancers tend to develop later in life once they’ve already had children. If this were the case, the increased risk of reproductive cancer risk would be passed onto the children, potentially initiating a domino effect in future generations. BPAs are used in medical devices and most types of food packaging. The biggest concern with BPAs is the leaching of harmful substances into the surrounding environment, a process enhanced by high temperatures. Now imagine the increase in exposure risk every time you put your plastic container in the dishwasher – your risk increases exponentially.

Phthalates are a group of plasticisers with flexible, pliable and elastic properties (Chou & Wright, 2006). They are primarily used to soften PVCs, the most frequently used materials in medical devices (Chou & Wright, 2006). Phthalates are also used in medical devices, toys and cosmetics. The exposure of phthalates from medical devices is well documented and is a major concern within the medical community (Karle et al., 1997), let alone the daily exposure involved in using cosmetic products. However, the exposure levels vary significantly between different hospitals (Chou & Wright, 2006), suggesting that exposure risk is linked to procedure specificity and the patient’s health conditions. For example, children are particularly vulnerable to these exposures since their immune systems are still developing, therefore a children’s hospital will have different exposure statistics to a general care hospital. On top of this, the use of phthalates in children’s toys is inconceivable; I doubt parents would still be buying these toys if they knew the associated risk.

During in vitro fertilisation (IVF) treatment, embryos are stored in petri dishes and transported with syringes and pipettes, hence there is inevitably a possibility of plastic leaching. Exposure to even small concentrations of BPA significantly affects embryo development stages and inhibits embryo implantation (Salachan, Teja, & Rajan, 2014). Embryos exposed to high BPA concentrations develop morphological abnormalities, such as scoliosis and head malformation (Salachan et al., 2014). Therefore, it is not out of the question that plastic leaching in IVF treatment would cause numerous problems for developing embryos, begging the question of how healthy IVF children are (Moll, 2022). This was tested in a lab in Milan, where they screened all the reagents and materials used in IVF, and toxicity was only detected when the instruments were analysed cumulatively, not when they were analysed individually (Delaroche et al., 2022). So, the more complicated the procedure, the greater the risk of plastic exposure. IVF treatments are a complicated process with many steps and, given the hefty price tag (over £10,000), people can’t afford to risk damaging and unnecessary plastic exposure that could otherwise be avoided, particularly since they often have no other option. When people start a course of IVF treatment, for many it may be a last-ditch attempt at having a child, and not everyone can afford more than one try.

To reduce or altogether remove the risk of plastic exposure in fertility clinics, we need to move towards using plastic alternatives in any way we can. There is plenty of ongoing work in the development of plastic alternatives, with many financially reliant on the outcomes. Most aim to make plastics more biodegradable, which is a potential issue for medical use, however these biodegradable products are simply recommended to be used only once or twice and then composted (Song, Murphy, Narayan, & Davies, 2009). Song et al. (2009) discussed the use of biodegradable plastics made from renewable raw materials such as starch and cellulose. Hunt, Lin, and Voulvoulis (2021) discussed replacing microbeads in cosmetics and identified alternatives, such as various plant and animal products, minerals, and plastics (Hunt, Lin, & Voulvoulis, 2021). While there is still much more to be done, current work is slowly but surely recognising that there are ways our society can function without a reliance on plastic and IVF treatments in fertility clinics can be carried out with little or no plastic exposure. Considering the risks posed to our future generations, there should be much greater urgency in our attempts to solve this issue, or we will all face the repercussions.

Literature Cited

Cantonwine, D. E., Hauser, R., & Meeker, J. D. (2013). Bisphenol A and human reproductive health. Expert Review of Obstetrics & Gynecology, 8(4), 329-335. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3811157

Castellini, C., Totaro, M., Parisi, A., D’Andrea, S., Lucente, L., Cordeschi, G., . . . Barbonetti, A. (2020). Bisphenol A and Male Fertility: Myths and Realities. Frontiers in Endocrinology, 11, 353.

Chou, K., & Wright, R. O. (2006). Phthalates in food and medical devices. Journal of Medical Toxicology, 2(3), 126-135.

Delaroche, L., Besnard, L., Genauzeau, E., Meicler, P., Lamazou, F., & Oger, P. (2022). O-268 Cumulative toxicity of plastic disposable devices used during IVF procedures. Human Reproduction, 37.

Hunt, C. F., Lin, W. H., & Voulvoulis, N. (2021). Evaluating alternatives to plastic microbeads in cosmetics. Nature Sustainability, 4(4), 366-372.

IBISWorld. (2022). Fertility Clinics in the US - Market Size 2003-2028. Retrieved from https://www.ibisworld.com/industry-statistics/market-size/fertility-clinics-united-states/

Karle, V. A., Short, B. L., Martin, G. R., Bulas, D. I., Getson, P. R., Luban, N. L. C., . . . Rubin, R. J. (1997). Extracorporeal membrane oxygenation exposes infants to the plasticiser, di (2-ethylexyl) phthalate. Critical Care Medicine, 25(4), 696-703.

Moll, T. (2022). Six Days in Plastic: Potentiality, Normalization, and In Vitro Embryos in the Postgenomic Age. Science, Technology, & Human Values, 47(6), 1253-1276.

Salachan, P. V., Teja, D. N. C., & Rajan, A. P. (2014). HOW SAFE ARE OUR BABIES? AN IN-SIGHT ON EFFECT OF BISPHENOL A (BPA) ON DEVELOPMENT. Journal of Drug Delivery and Therapeutics, 4(1).

Song, J. H., Murphy, R. J., Narayan, R., & Davies, G. B. H. (2009). Biodegradable and compostable alternatives to conventional plastics. Philosophical Transactions of the Royal Society B: Biological Sciences, 364(1526), 2127-2139. Retrieved from http://europepmc.org/articles/pmc2873018?pdf=render.